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Published on: March 24, 2023
[The Hartmann procedure in colorectal emergencies. Report of 76 cases]
M L Bisogno1, G Puntillo, P Aicardi
1I Divisione Chirurgica, Azienda Ospedaliera S. Giovanni, Addolorata di Roma.
Insights
The Hartmann procedure is increasingly used for emergency colorectal surgery. Risk stratification scores can help surgeons select the optimal operation for severe cases, improving outcomes.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Emergency Medicine
Background:
- The Hartmann procedure is a significant intervention in emergency colorectal surgery.
- Decision-making for this procedure relies on comprehensive clinical, radiological, instrumental, and pathological data.
- There has been an observed increase in the utilization of the Hartmann procedure for colorectal emergencies.
Purpose of the Study:
- To report the outcomes of 76 Hartmann procedures performed between 1986 and 1995.
- To compare these results with existing medical literature on the topic.
- To propose a risk stratification strategy to optimize surgical decision-making in colorectal emergencies.
Main Methods:
- Retrospective analysis of 76 Hartmann procedures.
- Comparison with published data on similar interventions.
- Evaluation of risk stratification scores (MPI, APA-CHE II, SSI, Hinchey) for therapeutic planning.
Main Results:
- The morbidity and mortality rates associated with the Hartmann procedure underscore the severity of treated clinical cases.
- The study highlights an increased application of the procedure in emergency settings.
- Risk stratification scores were proposed as a tool to guide surgical choices.
Conclusions:
- The Hartmann procedure remains a critical option for managing severe colorectal emergencies.
- Implementing risk stratification scores can aid surgeons in selecting the most appropriate surgical approach.
- Adherence to oncological surgical principles is crucial when managing colorectal cancer cases requiring emergency intervention.
Abstract:
The Hartmann procedure has, in emergency colo-rectal surgery, many implications. The decision is based on clinical, radiological, instrumental and pathological findings. The authors report the results of 76 Hartmann's procedures performed between 1986 and 1995 and compare their results with those found in the current medical literature on the topic. In particular, they draw attention to an increased use of this procedures in colo-rectal emergencies; the morbility and mortality rates confirm the severity of the clinical cases that can be treated with this operation. To improve results the authors propose a therapeutic plan that uses a score for stratification of the risk (MPI, APA-CHE II, SSI, Hinchey); so the surgeon can choose the best surgical operation. Finally, the authors underline the importance of the principles of oncology surgery in colo-rectal cancer.
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